Lyme In Chronic Illness

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Neuro-Lyme

In Chronic Lyme disease, the central nervous system is almost always effected to some degree. Those with learning disabilities, Autistic spectrum disorders, depression, mental illness, Alzheimers, suicidal and episodic anger/violent behavioral tendencies, should all be suspected as having been infected with Borrelia..

“Chronic or persistent Lyme disease–neuroborreliosis–seldom is identified by the symptoms of its most frequent form—subacute encephalitis–an infected/inflamed brain as well as an infected nervous system. However, this is the form in which it most commonly exists. Unfortunately, the syndrome that is falsely considered typical–a bull’s eye rash, fever, positive Elisa test, and/or a swollen large joint–occurs in fewer then half of proven cases. Instead, Lyme borreliosis confirms itself in subtle to profound neuro-psychiatric symptoms, such as overriding confusion, loss of organizational skills, decreased concentration, memory loss ,learning disabilities, mood disorders, irritability, and unprovoked rages–to mention just a few. These symptoms can be very obvious to an experienced professional practicing in a Lyme-endemic area. However, cerebral-behavioral symptoms of neuro-Lyme remain invisible to those whose diagnoses are solely based on old-fashioned concepts limited only to the aforesaid doctor-viewed rashes, swollen knees with positive Elisa blood tests.” Dr. Virginia Sherr MD, from ” An Inhumane Disease of the Brain”

Excerpts from “Aggression and Lyme Disease” written by Dr. Robert C. Bransfield MD

“Several years ago, I admitted a patient with Lyme disease (LD) to a psychiatric unit. He was para­noid and assaulted five police officers in an episode of rage. During the hospital stay, the patient went to the river behind the hospital to watch the Fourth of July fireworks display. When the fireworks began, the patient jumped into the river. It appeared the loud noise was responsible for an acoustic startle reaction.

At the same time, a female patient with LD was also on the unit. She described puzzling symp­toms that consisted of episodes of rage and intrusive, horrific homicidal images. In both cases, the aggres­sive tendencies improved with treatment. When we look at cases of aggression associated with LD, were all of these cases merely a coincidence or a causal relationship between LD and some of this aggressive behavior?

Adler methodically interviewing hundreds of patients over a period of years, it was clear that cer­tain patterns were emerging. The same problems were being seen in too many patients. A causal link was becoming increasing apparent. I would like to em­phasize that the vast majority of patients who know they have LD are not violent. It is not my intention to draw attention to an issue that further increases the stigma that LD patients already receive. However, it is my intention to methodically look at the association that does seem to exist between LD and aggressive behavior in a minority of chronic LD patients.

“It is well recognized that LD causes dysfunction of the central nervous system.” In the case of aggressive functioning, injury can lead to apathy (a failure of stimulation) and/or aggres­sion (a failure a inhibition, modulation, or association) Since circuits controlling aggression are often parallel with sex and feeding, we often see aggressive disor­ders in combination with sexual dysfunction and eat­ing disorders. Different patterns of brain injury result in different patterns of symptoms.

Now let’s look at the association between Lyme and aggression. The first reference on this sub­ject in the medical literature I could find was made by Fallon, et al in 1992 in ‘The Neuropsychiatric Mani­festations of Lyme Borreliosis”, in which he described a man acutely sensitive to sound was so intensely both­ered by the noise his three-year-old son was making that he picked him up and shook him in a sudden and unprecedented fit of violence. Other cases can be found in medical literature cited at Lyme meetings and in newspaper reports. The phrase “Lyme rage” continues to appear on the Internet. There are discussions that some “road rage” is caused by “Lyme rage”.

I would estimate aggressive behavior has been a significant issue for approximately fifty patients with LD that I have evaluated or treated, although many more have reported some symptoms associated with aggressive potential. When aggression does occur, it may only be present for an interval in the progression of the illness.

Deficits caused by LD that are sometimes as­sociated with increased risk for aggressive behavior may include:

1. Decreased frustration tolerance. (This is magnified by the increased frustration caused by a chronic illness).

2. Decreased impulse control.

3. When mild, the combination of decreased frustra­tion tolerance and decreased impulse control leads to irritability. When more extreme, this combination can result inexplosive anger.

4. Hyposexuality and hypersexuality caused by LD, both of which cause increased interpersonal frus­tration.

5. Dysfunction causing different forms of obsessive compulsive disorder, which results in intrusive thoughts, images, and compulsions that sometimes are of an aggressive nature.

10. Some patients acquire impairment in their ability to regulate the arousal level of an emotion. As a result, emotions such as anger may be all or none, excessively intense, and not proportionate to the current situa­tion. This also leads to a decline in the ability to integrate concurrent emotions that exist either within the patient or in a relationship with another person. This symptom may in turn intensify other psychiat­ric syndromes such as post-traumatic stress disor­der, dissociative disorders, borderline personality, and narcissistic personality disorders.

Any combination of the above impairments can result in aggressive behavior. When these changes occur in a mature adult, the patient is surprised by the symptoms – they recognize it is pathological and attempt to compensate for the deficits. However, children who never had the reference point of a mature level of functioning are at a greater risk. Some of the most threatening cases were patients who were infected at a young age.

Control over physical well-being is lost with Lyme, but much more disturbing and debilitating is the lack of control or normalcy of the mind both emotionally and cognitive – perhaps worse during a flair when all symptoms often rear their ugly heads. It is a crushing experience to survive these images feeling possessed or evil. If they were to be continuous and not fleeting, no-one could or would survive.”

In another case, a patient had no prior history of mental illness suicidal or homicidal tendencies. -The patient went to their HMO –primary care physician complaining of an apparent tick bite. It is reported that the doctor neither sent the patient for testing nor initially offered antibiotic treatment. As symptoms progressed, the patient was diagnosed with fibromyalgia. Subsequent symptoms included word substitutions, getting lost, losing items, and an inability to find their car in a parking lot. Eventual tests confirming LD included a Western Blot, brain SPECT, and an ophthalmologic exam.

The patient improved with treatment of several weeks on IV antibiotics and was stopped as per the managed care guidelines. The patient relapsed and further treatment was denied. Their mental state declined and subsequently there was a combined homicide-suicide.

In conclusion, based on my observations and clinical judgment, chronic relapsing LD at times causes aggressive behavior, which can manifest in a number of different forms. Since this is aggression associated with a CNS infection, it can potentially be treated and prevented. If only a small percent of chronic LD patients are affected, the total number of cases is still quite significant. Since this is a late stage manifestation, the increasing number of individuals infected with Bb raises serious concern that violence associated with or caused by LD will increase in the future.

What can we do now to prevent a possible future epidemic of violence? Suggestions include high index suspicion for Lyme disease in rageful people, adequate testing for Lyme disease in those who are enraged, adequate treatment of LD, contin­ued LD advocacy efforts, research into the link between aggression and LD, evaluation of violent offenders who demonstrate some of the aggressive patterns seen with LD prior to their release into the community, and vaccinations. When regional epidemics of violence occur, LD and other causes of encephalopathy should be considered. We should exercise every option to prevent crime with medical treatment.”

There is also a link between Lyme and Autistic Spectrum disorders and learning disabilities. The Lyme-Autism Connection, a book written in collaboration with the Lyme-Induced Autism (LIA) Foundation, provides critical new research on the emerging science supporting a link between Lyme disease and childhood developmental disorders.

“Awareness of the Lyme-autism connection is spreading rapidly, among both parents and practitioners. Medical Hypothesis, a scientific, peer-reviewed journal published by Elsevier, recently released an influential study entitled “The Association Between Tick-Borne Infections, Lyme Borreliosis and Autism Spectrum Disorders.” Here is an excerpt from the study:

“Chronic infectious diseases, including tick-borne infections such as Borrelia burgdorferi, may have direct effects, promote other infections, and create a weakened, sensitized and immunologically vulnerable state during fetal development and infancy, leading to increased vulnerability for developing autism spectrum disorders.

An association between Lyme disease and other tick-borne infections and autistic symptoms has been noted by numerous clinicians and parents.”

There is also a connection between Lyme infection and Alzheimer’s Disease. The following is from the Lymedisease.org website, entitled “Can Lyme Disease Cause Alzheimer’s Disease?”

The cork-screw shaped bacteria that causes Lyme disease, Borellia burgdorferi (Bb), are called spirochetes. Other types of spirochetes include those associated with syphilis and dental spirochetes. Chronic spirochetal infection can cause slowly progressive dementia, brain atrophy and amyloid deposition in late neurosyphilis. A new study by Dr. MiKlossy, reviewed all the data available in literature to determine the role that spirochetes, including Bb, play in Alzheimer’s disease (AD).

The results of Dr. MiKlossy’s review found a statistically significant association between spirochetes and AD. Spirochetes were observed in the brain in more than 90% of AD cases. Bb was detected in the brain in 25.3% of AD cases analyzed and was 13 times more frequent in AD compared to controls. Importantly, coinfection with several spirochetes occurs in AD.

The analysis of reviewed data followed the principles of Koch and Hill necessary to establish causal relationship between illness and pathogens and found a probable relationship between spirochetes in the brain and AD. As suggested by Hill, once the probability of a causal relationship is established prompt action is needed. Support and attention should be given to this field of AD research. Spirochetal infection occurs years or decades before the manifestation of dementia. As adequate antibiotic and anti-inflammatory therapies are available, as in syphilis, one might prevent and eradicate dementia.